Alcoholic Pancreatitis

ByI. D. Norton, J. S. Wilson

Alcoholic pancreatitis is an important complication of alcohol abuse, occurring in up to 5% of heavy drinkers. It is generally a chronic disorder, resulting in significant mortality and a morbidity characterized by malabsorption, malnutrition, abdominal pain, diabetes, and the frequent need for surgery. Pancreatitis is generally classified as either "acute" or "chronic." Acute pancreatitis typically presents with constant abdominal pain and raised serum levels of pancreatic enzymes due to inflammation of the gland. The distinction between acute and chronic pancreatitis is often difficult in the initial stages: acute pancreatitis can recur, and chronic pancreatitis often presents initially as an acute episode, clinically and biochemically indistinct from "acute" pancreatitis. The pathogenesis of alcoholic pancreatitis has not been elucidated, mainly because of the lack of a suitable animal model of this disorder and practical difficulties in obtaining pancreatic tissue from patients during various phases of the disease. Alpha1-antitrypsin is the major protease inhibitor of serum.